MEDICARE: MR. ALBERT ALLAN HUITRIC M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	23973	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23973	OTHER	CA	MFT

General Provider Information

NPI Number	:	1154481067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT ALLAN HUITRIC M.S.

Provider Business Mailing Address
First Line	:	2891 CHURN CREEK RD
Second Line	:	SUITE B
City	:	REDDING
State	:	CA
Zip	:	96002-1148
Country	:	US
Telephone Number	:	530-226-1634
Fax Number	:

Provider Business Practice Location Address
First Line	:	2891 CHURN CREEK RD
Second Line	:	SUITE B
City	:	REDDING
State	:	CA
Zip	:	96002-1148
Country	:	US
Telephone Number	:	530-226-1634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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